The benefits
of best rest (or lying on a couch or the floor) in multiple
gestation has always been debated by doctors. However, TTTS
is a high-risk complication in which all possible beneficial
remedies should be utilized to improve outcomes. Horizontal
rest should be used. Horizontal
rest (on the mom's side) will help blood flow and oxygen to
the womb, and aid in removing some of the excess edema fluid
in patient's body. Work is
problematic for many women affected by TTTS. Studies have
shown a definite relationship of physically demanding work
to adverse outcome in pregnancy. Given the high-risk nature
of a TTTS multiple pregnancy, we recommend a leave of absence
for the duration, especially if the patient is undergoing
one of the treatments outlined above.